dcs or not? What to do now...

[doanotherdive]

Greetings Doctors,
I have read through as many of the other posts as I could but still could not find the answer to the question that I have.

I am a dive instructor teaching the full spectrum of class's from O/W to DM. In the last year I have had a couple of instances where after a day of diving, I have had what could have either been a case of DCI or maybe not. Once or twice I have felt tingling in an arm or hand and just wanted to take a nap. While loading up the trailer, these feelings turned to light headed-ness and increased discomfort. I usually had to stop and take a break. After getting back to the hotel I would take a nap and feel just fine. The next day diving would normally go without any problems. A couple of times though these feelings would return, mostly with O/W students where I would have to do a bunch of CESA's.

My background is I have been diving over 14 years and teaching for about 10 years. When I first became an instructor I spend 3 years in the carib diving 3 times a day 6 days a week. I never had any problems but lets just say I was not always the healthiest diver everyday. After work happy hours at times went late into the evening and work came early. Like I said, I never felt any problems or had any concerns back then.

I did get burnt out though and took a couple of years off and returned to the mainland for some dry times. I am now turning 30 and still in good shape with regular exercise. Drinking is no longer a factor, but stress may be. These occurrences, like I said, are most evident when having to do multiple CESA's or yo-yo students. The dive profiles for OW are never deeper than 35ft but average in the 20ft for most of the time.

I had some bouts of tiredness on a weeklong trip last summer, mostly towards the end of the week. Once again nothing that a nap did not cure, and water was my drink of choice for the week. The profiles were 80 first and 60 second each day with one day off in the middle.

If there is more information needed I am happy to share.

The question is should I be concerned, and if so is there anything that can be done this late? I have not dove in over a month but have 4 big trips coming up in the near future and would hate to have to find out then.

Teaching has now become a full time job and therefore the words "no more diving" would be devastating on both a professional and personal level. Please tell me that everything is ok or that it can be resolved.

Thank you for your time and advice.

Doanotherdive

 

[Boogie711]

Share with DAN. This board is fantastic for generic advice or theory regarding dive related medical queries, but you're getting pretty specific. If I were you, I'd want answers.

919 684 4326 - call DAN.

 

[doanotherdive]

Planning on it only thought I would check here first. See what others may think as well.

Doanotherdive

 

[DocVikingo]

To the best of my understanding, there are not two worlds of diving medicine knowledge, one available to the Medical Regulators & and other health care professionals who frequent Scubaboard, and a different one available only to DAN. I'm quite confident that we all rely on essentially the same corpus of science, theory and anecdote in responding to dive medicine inquiries, be they general or specific.

In my view, the Diving Medicine/Dr Deco forums do in fact endeavor to provide specific answers when they exist. However, the truth is that within the realm of diving medicine/decompression science definite answers frequently do not exist. When this situation obtains, the ethically and legally prudent thing to do is to provide general guidance based on limited research and/or theory.

Perhaps because of its organizational status and liability coverage DAN may feel more at ease in providing direct answers, but often they do not do so. I'm not sure how many DAN responses that you have seen, but I've seen many and often they are as indirect and non-specific, if not more indirect and non-specific, than those found on Scubaboard.

I happen to think that it's a very wise idea to share with us.

This having been said, your suggestion that "Doanotherdive" contact DAN remains a good one. This can be done through (919) 684-2948 (Mon thru Fri, 9AM-5PM EST), or e-mail a DAN Medic at http://www.diversalertnetwork.org/c...sp?re=Medicine.

Best regards.

DocVikingo

 

[DocVikingo]

As your inquiry appears to be one of a medical nature rather than "...the scientific aspects of decompression," the focus of the Ask Dr Decompression forum, I have taken the liberty of moving it here. Dr Deco still will see your question.

Based on the history you have given, it is not possible to say with certainty whether your complaints are DCS-related or not. They do, however, fall well within the range of suspicion and therefore merit more intimate attention by a physician versed in diving medicine.

When you inquire of DAN, you might ask for a referral source. If they do not have one, perhaps I might know of a professional in your area.

I would ask that you please post within this thread any response from DAN.

Best of luck.

DocVikingo

 

[Dr Deco]

Hello Doanother:

DCS Problems

The truth of the matter is that there are many varied responses to decompression. Having worked with a number of different animal species over the past several decades, I am surprised to find very unexpected results in the outcome of a dive that I thought would produce something quite different. In most every case, it is not possible to tell what occurred.

In your case, if the problem/situation appears often following a dive, it is very suspicious that diving is a causative factor. That is not to say that DCS and bubble production is the cause but something, anyway, to do with diving. There are neurological disorders that are exacerbated by strenuous activity (especially in heat), and possibly you are experiencing some difficulties in this regard. One might need to speak with a neurologist and explain the particulars of your situation.

In addition, if the problem remits when you descend, that is a definite suspicion that a gas phase is related to the problem. If the initial descent plays no role at all, I might think of something other than a gas phase problem.

As DocVikingo states, it is not really possible to evaluate all of the divers by e-mail. This requires an examination by someone proficient in medical studies. It is very true that there are often differences between answers DAN provides and what you might read from me (or others) on Scuba Board. While we share much of the same material, we do differ in our backgrounds and experience. Witness the differences of opinion regarding the RGBM as have appeared here. [This is not concerning whether they work, but explanations of why they work and to what physical effects we should attribute the success.]

Dr Deco :doctor:

 

[Wreckie]

Some practical, non medical type ideas: physical activity should be avoided after diving, this includes loading the trailer (and for those of us in the uk winching the boat out of the water, but we all still do it).

Take a rest before you load up (eat, drink, do a de-brief, teach your class something that way they wont even know its an enforced artificial break). If its a beach dive make two trips to bring your kit up, if its a boat dive hand in your weight belt before climbing in.

Chainge the gas your breathing, nitrox is fantastic for fighting that horrible tired feeling. Once you get out keep breathing it either as you walk up the beach or sit on the boat for a few minutes. sit with a small slate 'making notes' about your students that way no-one will annoy you for five minutes or so.

I know you said you were fit but have you 'grown' a little snug for your suit, my hands used to go numb after dives, turned out it was due to my wrists and hands swelling becouse my wrist seals were a little snug, of course once they swelled it just went round in circles and got worse.

Hope this helps

Mike